What can I expect during an EMDR session? Understanding the 8 phases of EMDR
EMDR is a phase-based approach for addressing traumatic or stressful experiences from the past that are impacting us in the present. The different phases each address specific parts of trauma recovery. This is because recovering trauma is about more than working through what happened, it’s also about restoring and solidifying our internal sense of safety and weaving the past into our story to ease its impact.
EMDR has eight phases in total. Adhering to these phases is important because it ensures safe and thorough processing. However, it does not need to feel like a set of strict, regimented steps.
To explain the eight phases of EMDR in a way that is practical, I condense them slightly—the eight phases tend to take place over three types of therapy sessions. Below, I outline how the eight phases of EMDR fit into these three types of sessions.
Understanding three different types of EMDR sessions
One way to think of these three types of sessions is using the metaphor of a trail. Below, I’ve woven this into the explanations of each type of session.
Resourcing Sessions
You can think of resourcing sessions as preparation to walk down a trail that perhaps feels unfamiliar at first. We focus on gathering what you need to walk down this trail. Eventually, we approach the trailhead to make sure you have gathered the supplies, mindset, and sense of safety with your guide (the therapist) to begin walking. We sense what it is like to stand at the trailhead, discerning whether we have done the necessary work of preparation and adjusting the plan as needed.
Phases of the EMDR protocol: Phase 1: History taking and planning, Phase 2: Preparation
Primary Focus of the Session: Understanding present day and in-the-moment experiences, discussing current motivations for treatment, identifying future hopes and desires
What to Expect: These sessions involve some talk therapy and some non-talk therapy. You can expect to identify which internal obstacles, strong emotions, and/or beliefs are standing in the way of your future hopes and desires, and discussing with your therapist how EMDR can help you to do the kind of work you would like to do. During these sessions, you will start to develop coping skills and resources so you can access feelings of calm, strength, or compassion when you need them. We use bilateral stimulation (BLS) to enhance these feelings and help make them easier to access. BLS is done through back-and-forth tactile tapping, audio, or eye movements.
Reprocessing Sessions
You can think of reprocessing sessions as walking down the trail. At the start of the trail, limiting beliefs feel quite strong and quite true. For example, “I can’t do this, I’m not strong enough”. The way these beliefs feel in your body might be apparent. For example, feelings of apprehension or fear showing up as tension or discomfort. However, these feelings will not overwhelm you because you have your resources and the presence of your therapist. The entire time, you are in control of where you walk and how far. Your therapist is also there to help make sure that you’re going the right way. As you leave the trailhead and begin to walk, the old beliefs and associated feelings lose their strength. You begin to access new beliefs that reflect the truths you know about yourself but have been clouded by past experiences. For example, “I can do things that are uncomfortable, I’m strong enough to try”. Sometimes, we reach the end of the trail because the past memory and its associated beliefs/feelings/body sensations have resolved. Other times, we go as far as we can go and we leave the trail, knowing there is more ground to cover and that we will return another day. Either way, you spend a bit of time at the end sensing what it is like to have done this walk and utilize new skills or resource to take care of any residual feelings of stress and/or tension before the walk is finished.
Phases of the EMDR protocol: Phase 3: Target assessment, Phase 4: Desensitization, Phase 5: Installation, Phase 6: Body scan, Phase 7: Closing
Primary Focus of the Session: Working through past experiences, Working through present day triggers
What to Expect: These are not like traditional talk therapy sessions as the majority of the session is spent using BLS to reprocess. You will usually begin by identifying an experience for reprocessing (usually a past memory which is connected to a present day limiting belief, but it can also be a recent memory). From there, you begin reprocessing using bilateral stimulation (eye movements, audio, or tactile). During reprocessing, you will alternate between sets of BLS and simply telling your therapist what you are noticing internally. This continues until the experience is no longer distressing or upsetting to you. After that, you identify new beliefs that fit your current experience, hopes, and desires and enhance any positive feelings that are associated with the new beliefs, again with bilateral stimulation. To conclude, you will practice checking in with your body by doing a body scan and noticing any remaining areas of stress or tension within your body. You will use BLS while focusing on these sensations as they dissipate. The conclusion of the session is focused on debriefing and/or exercises to help you feel calm and/or strong.
Integration Sessions
You can think of integration sessions as the work that is done after completing one trail or in between stopping one trail and resuming where you left off. During these sessions, you reflect on what feels different and what feels the same after walking the trails you have walked. Reflecting in this way can help you to understand which trails feel complete and which trails you may want to walk down next. Your experiences with walking these trails can help you to feel more confident in selecting where you go next, and hopefully you begin to feel more confidence and mastery about your ability to walk down trails that were previously unvisited. You may also begin to sense that you have done enough walking and you would like to pause and enjoy your accomplishments. Your ability to access your resources and feel the support of your guide (therapist) is strengthened when taking the time to reflect on the positive changes you are noticing about yourself.
Phases of the EMDR protocol: Phase 8: Re-evaluation, Phase 1: Planning (Sometimes also Phase 2, Preparation)
Primary Focus of the Session: Present day changes in experience as a result of processing, Future focus on hopes and intentions
What to Expect: These sessions feel more like traditional talk therapy sessions. Your therapist’s job is to support you in your growing understanding of who you are and how you relate to your past. Several different things you can potentially be speaking about are: changes in present day symptoms, emotions, and beliefs, speaking about new developments and possibilities, identifying next steps based on progress so far, integrating old memories into your story by looking at them differently, identifying new sources of safety and connection in your life, identifying ways in which you can live more in alignment with your new beliefs and letting these intentions guide your experiences outside of sessions, and talking about the moments of choice, agency, and empowerment that are becoming available to you as a result of processing. Hopefully, there is also time dedicated to speaking about what is helping you to feel stronger and more confident about your ability to face challenges related to your past, present, or future!
No two treatment approaches are identical
In my view, therapy should be unique to you!
The application of these eight phases and the types of sessions you will experience in EMDR will vary based on your therapist’s approach and the collaborative planning that is done to tailor the experience for you. Below is an example of a treatment flow I guide clients through in my practice.
Resourcing phase: 1-10+ resourcing sessions focused on identifying what themes, symptoms, and beliefs you would like to address, and developing resources that will help you to build up the capacity, strength, and inner flexibility to reprocess the past experiences that are linked to your present experiences
Reprocessing phase: 3-10+ reprocessing sessions to work through identified memories/targets using bilateral stimulation, and with regular attention paid to resourcing and coping skills throughout, especially at the start and end of each session
Integration phase: 1-3+ integration sessions to help make sense of your past experiences from a new perspective, reflecting on overall progress and identifying any additional areas of concern, or deciding you’ve gone as far as you’d like to go and concluding or pausing sessions
For longer-term therapy, this entire process can repeat for each individual “issue” or “theme” that someone would like to address. For shorter-term therapy, this process is usually applied to just one single “issue” or “theme” and sessions conclude or pause once the client feels that they have got what they needed from therapy.
Something else to keep in mind is that each session will likely include elements of all three phases mentioned above. For example, you could be in the reprocessing phase and also be engaging in moments or “mini sessions” of resourcing and integration. Lastly, some people benefit from a less linear approach. For example, you could decide that after the initial resourcing phase, alternating between reprocessing and integration sessions is what feels most supportive to you.
Conclusion
One of my favourite things about EMDR therapy is that it can support a sense of mastery and confidence around processing things that once left us feeling alone, unsafe, helpless, or powerless. I love it when clients feel more comfortable with the process and begin identifying what it is they most need for their session—resourcing, reprocessing, integration, or some combination of these! When my clients feel a sense of agency in therapy, and sense that I am their collaborator, I know we are working well together.
